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Lipstick Nipple/Latching Problems

We are having some problems breastfeeding and I'd really like some advice.

We had a very difficult birth (30 hours followed by a c-section) which resulted in my breasts becoming swollen. Between the swelling and my milk coming in in abundance, my nipples became flattened which prevented my baby from being able to latch on. We went to a lactation consultant and she set us up with an SNS system and a nipple shield so that he could eat at the breast and we could monitor how much milk he was getting (he was losing weight so it was important to make sure he was getting enough).

We made it through those early days and now, at two and a half weeks we are feeding directly from my nipple.

His latch looks perfect from the outside (flanged lips, my entire (small) areola is in his mouth) and he eats happily. BUT it hurts! And when he finishes my nipple is compressed into the lipstick shape everyone talks about.

I've been reading about this and it sounds like we need to get a deeper latch - to get the nipple further back into his mouth. But how do I do that? I've tried just about every position possible and we've tried letting him latch himself of and making a breast sandwich and trying to get as much as possible into his mouth. So far, it's still hurting and we're still getting the lipstick shape.

I would LOVE to hear any suggestions that you may have on how to help us!

Re: Lipstick Nipple/Latching Problems

so if the latch FEELS off its probably off even if it "looks" good.

how old is your lo? 2 weeks? very little still so its very early. their mouth is probably very small still. you may have a bit of a lipstick look for a little bit simply because their mouth is small but if its really pronounced and you are having pain the latch needs work.

also, are you sore on your nipple or cracked? that can be super painful esp if the latch is off. i used to keep lansinoh cream in my pocket to keep it warm and i just slathered it on. i wore old tank tops and didnt care if it got all over them. try to let your breasts get some air when you can.

as for the latch itself:

i found that i needed to really work at my latch with my second son every time. i found the football hold worked best when he was small and we were still getting the hang of things.

i would hold his head/neck in one hand and my breast compressed like a sandwich in the other hand. then i would touch the top of his mouth with the nipple and when he opened his mouth i would aim the nipple toward the top of the inside of his mouth. NOT the middle.

the problem is they open and close so quickly and you are desperate to get it right. and you are tired and they are tired and hungry. it can become very stressfrul very quickly. I would try to take deep breaths, drink some water and try again as much as we needed to.

if its off you need to break the seal of their mouth and try again. try to stay calm. you are doing a great job and its soo early still.

i found the book the womanly art of breatfeeding to be super helpful and calming so i read it while i nursed. i highly recommend it!

Re: Lipstick Nipple/Latching Problems

OK - so, he may just need to grow a bit larger in order to take enough nipple into his mouth to make this work? About how long does that take? I'm sure it's different for everyone but anyone have an estimate?

If that's the case, will I still get the lipstick shape until his mouth catches up? What about the nipple pain? Will that continue until his mouth is larger or does that just mean that we have a poor latch that we need to work on?

My nipples are sore but no longer cracked or too damaged looking. When he first latches on it REALLY hurts for about a minute and then subsides into a more manageable pain level. Since they're already sore, I'm having a hard time figuring out if the latch has improved at all or if it's just hurting because the nipples are already damaged.

I did just try the football hold (haven't used that position in a little while) with the deep latch technique featured here:

And it was better! Slightly less pain and the lipstick look wasn't quite as pronounced (though we definitely still had the lipstick nipple going on). I'm not sure if it was better because he was just hitting the nipple in a different place or if the latch really was better. I'm going to try this position again at the next feeding and see what happens.

Re: Lipstick Nipple/Latching Problems

The PP gave excellent advice!

I wish i could tell you when your baby will grow enough to stop hurting you, but it's so different for every mama. With my first baby, it took 5 months. With my second, it took less than 3 weeks. I think the fact that you are no longer cracked is a good indication that your pain experience will be on the shorter end, though!

I'm glad you found the football position helpful. When you have really sore nips, it's important to vary your nursing position and look for the position that is less ouchy. Sometimes just having baby's mouth fall into a slightly different position can ease the pain on your sorest spots and make nursing more tolerable.

Hang in there! You're doing an awesome job and I promise that it will get better!

Re: Lipstick Nipple/Latching Problems

Re: Lipstick Nipple/Latching Problems

Today was ok. We tried a different position for each feeding which helped keep the pain to a manageable level. I guess he hits the nipple in slightly different places so it doesn't get so sore?

Still getting the lipstick shape each time though and the feedings are still very uncomfortable. My nipples look better than they did originally though so that's good. I just can't get the nipple far enough into his mouth! Or at least that's what I think I need to do. Or wait for him to get bigger.

He's been doing something bad though - trying to pull off of the nipple without unlatching. Ouch! He did pull off twice like this and boy did it hurt! Any suggestions on how to discourage that?

We have another appointment with the lactation consultant on Tuesday though. I really hope she can help me with his latch! I just don't know what we're doing wrong!

Re: Lipstick Nipple/Latching Problems

There are a couple of reasons why babies pull back to a shallower latch. Sometimes the baby is losing the latch on the breast because his mouth is getting tired out by pulling against the weight of the breast- imagine if you had to hold up a water balloon bigger than your head using only your lips, tongue, and gums! When this is the problem, supporting the breast throughout the feeding, using your hand or a rolled-up washcloth tucked beneath the breast, may help.

Sometimes babies pull back/clamp down because they are trying to control a fast flow of milk. Compressing the nipple is like crimping a hose. This is most common in babies whose moms have oversupply, which is the most common cause of extremely rapid milk flow. If you notice a lot of the following, oversupply could be in the equation for you:
- frequent feelings of engorgement or fullness
- milk sprays or streams from the breast if baby lets go while nursing
- lots of leaking (soaking multiple breast pads in a day)
- mom may be able to pump multiple oz of milk with ease, if she is pumping
- baby may choke, cough, gag, splutter, or make a clicking/clucking sound while nursing
- baby may pull off the breast while nursing
- feedings may be rapid, as little as 5-10 minutes
- baby's poops may be frequently or consistently green (we're talking anywhere from fluorescent green to spinach green)
- baby will likely gain weight rather rapidly
- baby may be very gassy
If fast letdowns are a problem for your baby, start by trying reclined nursing positions, using gravity to work against milk flow.

Re: Lipstick Nipple/Latching Problems

Thanks so much for the tips!

I don't think breast support is a problem. I have small boobs so I don't think he's having to hold them up at all.

I'm not seeing many signs of oversupply except lots of leaking but the LC said I was producing enough to feed twins so that could definitely be the problem. Other than the latch he seems ok with it though - doesn't pop off the breast, good strong sucks throughout and be usually feeds 30-60 mInutes. No alarming diapers either. He's a big baby (about 9lbs) and a big eater according to our last weigh in (he seems to take about 3oz right now).

We have tried lying down and reclined breastfeeding with the same pain/lipstick results. Do you think I should try to pump a little before feeding? If he'll wait that long!

Re: Lipstick Nipple/Latching Problems

Avoid the pump. Your body interprets additional stimulation and milk removal as a sign to increase production, and if you have any oversupply issues you risk making them worse. The only reason you might want to pump a very small amount before feeding would be if you have very flat or inverted nipples, and the pump would draw them out enough to allow a pain-free latch.

Re: Lipstick Nipple/Latching Problems

Well, it doesn't hurt as much anymore. It still really hurts but I don't feel like I need to bite down on something through the entire feeding anymore. We're still getting the lipstick shape but I feel like it's less pronounced but that could just be wishful thinking. It still looks pretty bad when he's finished with it.

The LC said his tounge movements are too strong and we should help him tone it down with some suck therapy. So, we're working on that.